Inm-4: Supportive and Educational Role of The Nurse and Midwife with A Focus on Patient-Centered Infertility Centers

s:3294:"Delivering high-quality care is the ultimate but challenging goal of healthcare. In all fields of healthcare, effectiveness and safety are the most acknowledged quality dimensions. Although crucial, true high quality care goes beyond this scope, and is also patient-centered. Patient centeredness is defined as ‘care that is respectful of and responsive to individual patient preferences and needs and that is guided by patient values.’ Patient centeredness "encompasses qualities of compassion, empathy, and responsiveness to the needs, values, and expressed preferences of the individual patient." In addition, translation and interpretation services facilitate communication between the provider and the patient and are often a legal requirement. The patient-centered approach includes viewing the patient as a unique person, rather than focusing strictly on the illness, building a therapeutic alliance based on the patient's and the provider's perspectives.Providing relevant information to patients, respecting their wishes and considering their capacity to make treatment decisions is crucial for high-quality and patient- centered fertility cares, resulting in patients who are well-informed, better adjusted to their circumstances and is compliant with their treatment. Fertility patients generally appear to be satisfied with the information they are given but a significant minority is not. Giving information to infertile patients is complicated by the nature of their condition, desire for a child and complexity of treatment options. Patients need detailed, well-timed information to support difficult decision-making, such as when to end treatment. Four reasons clearly indicate the need for reproductive medicine to focus on other quality dimensions besides ‘effectiveness’ (pregnancy rate), in particular the ‘patient centeredness’ of care. First, ‘patient-centeredness’ is important to all segments of health care, and it is defined as one of the six dimensions of quality of care. Secondly, despite the success of current Medically Assisted Reproduction, one-third of the infertile couples finally do not deliver a child. Hence, process indicators such as patient-centeredness are very important in addition to outcome indicators. Thirdly, recent reports confirm that besides effective medical treatment, patients also want patient-centered infertility care. Fourthly, infertility and its treatment involve a physical and emotional burden for both women and men and that burden contributes to high drop-out rates from treatmentFor instance,patients who voluntary dropped out from treatment have reportedthe impact of the psychological burden (72%) and the lack of staffempathy (32%) on their decision. Education, often delivered by nurses and midwives, is an important part of all management programmers for infertile patients, both in clinical practice and research. Most infertile clients at different times during their treatment also need emotional and social support, which nurses can provide. So, emotional and educational support and interventions from nurses would complement and reinforce all other interventions for infertile clients undergoing treatment.";